Teladoc Health and Amwell, two of the largest telehealth companies, posted gains in their revenue this week for 2021, building on a spike experienced in the first year of the COVID-19 pandemic.

Boston-based Amwell on Thursday reported $252.8 million in full-year revenue, up 3.1% from $245.3 million the year prior and up 69.8% from $148.9 million in 2019.

Amwell’s revenue was roughly split between subscription revenue at $108.3 million, up 10.1%, and visit revenue at $116.6 million, down 0.5%. The company posted 5.8 million visits for full-year 2021, down slightly from 5.9 million in the previous year. 2020 had represented a massive increase from 1.1 million visits pre-pandemic in 2019.

Purchase, New York-based Teladoc, which reported earnings Tuesday, posted $2 billion in revenue for last year, up 85.8% from $1.1 billion in 2020 and 267.4% from $553.3 million in 2019, and 19.5 million visits, up 46.8% from 13.3 million in 2020 and 4.1 million in 2019. Most of Teladoc’s revenue came from subscriptions at $1.7 billion, up 104.4%, with $254.2 million from visit fees, up 14.8%.

Amwell posted $72.75 million in revenue for the fourth quarter, up 20.4%, and 1.5 million visits, down slightly from 1.6 million in the year-ago quarter. Teladoc’s fourth quarter revenue was up 44.6% year-over-year at $554.2 million, with 5.4 million in quarterly visits, up 28.1% year-over-year.

Amwell expects to report revenue between $275 million and $285 million in 2022. Teladoc expects to report revenue between $2.55 billion to $2.65 billion.

Despite their revenue growth, neither Teladoc nor Amwell are profitable.

Amwell posted a $176.8 million net loss for 2021, compared to a $228.6 million net loss in 2020. Teladoc reported a $428.8 million net loss, compared to a $485.1 million net loss last year.

Teladoc and Amwell in recent years have been working to integrate their telehealth services more deeply into patient careexpanding from one-off video-enabled urgent care visits they were once known for.

“The pandemic dramatically accelerated telehealth adoption,” said Dr. Ido Schoenberg, Amwell’s chairman and chief executive officer, on a call with investment analysts Thursday. “Urgent care visits have been commoditized. Providers, payers and innovators are now seeking to realize the much broader potential of hybrid care.”

Amwell has been rebranding as a technology company that provides the tech infrastructure for hospital and health plan customers, with less of a focus on providing care through its own clinician network.

Most of the visits on Amwell’s platform in 2021 were conducted by health system and health plans customers’ own clinicians, with only 24% conducted by Amwell’s medical group, a trend Schoenberg has said he expects to see continue.

By contrast, Teladoc reported 4.4 million visits through its network of clinicians and 982,000 visits conducted with customers’ own clinicians.

One of Amwell’s core priorities for 2022 is completing its build-out of Converge, a product it launched last year. Converge is designed to provide customers with a single access point for products and applications from Amwell, which customers will be able to subscribe to depending on their needs. The platform includes applications Amwell partners including Google Cloud and Cleveland Clinic.

Amwell plans to continue to add modules to the platform this year.

It’s part of Amwell’s “land and expand” strategy, in which the company sells additional services to its existing customers, said Robert Shepardson, chief financial officer, on the call Thursday. Amwell’s average annual contract values ??in 2021 increased from $334,000 to $356,000 for health system customers and from $612,000 to $723,000 for health plan customers.

Roughly 60% of Amwell’s bookings over the past year or so have been sales to existing customers, Shepardson estimated. He expects that to rise to 75% over the next few years.

“Once we’re in, there’s ample opportunities to upsell,” Shepardson said.

Teladoc’s next phase of growth will focus on expanding a virtual primary-care product it launched last year, mental health services and continuing to build out its chronic care services, said Jason Gorevic, Teladoc’s CEO, on a call with investment analysts Tuesday. Teladoc earlier this month announced a chronic care management program that ties in capabilities from Livongo, which Teladoc acquired in 2020.

Multi-product sales represented 80% of full-year 2021 bookings, Gorevic said.

“Our vision is to become the first stop in the consumer healthcare journey, regardless of need,” Gorevic said. “From physical to mental, acute to episodic, and chronic to complex.”